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      Biomonitoring of Lead, Cadmium, Total Mercury, and Methylmercury Levels in Maternal Blood and in Umbilical Cord Blood at Birth in South Korea

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          Abstract

          With rising concerns of heavy metal exposure in pregnancy and early childhood, this study was conducted to assess the relationship between the lead, cadmium, mercury, and methylmercury blood levels in pregnancy and neonatal period. The study population included 104 mothers and their children pairs who completed both baseline maternal blood sampling at the second trimester and umbilical cord blood sampling at birth. The geometric mean maternal blood levels of lead, cadmium, total mercury, and methylmercury at the second trimester were 1.02 ± 1.39 µg/dL, 0.61 ± 1.51 µg/L, 2.97 ± 1.45 µg/L, and 2.39 ± 1.45 µg/L, respectively, and in the newborns, these levels at birth were 0.71 ± 1.42 µg/dL, 0.01 ± 5.31 µg/L, 4.44 ± 1.49 µg/L, and 3.67 ± 1.51 µg/L, respectively. The mean ratios of lead, cadmium, total mercury, and methylmercury levels in the newborns to those in the mothers were 0.72, 0.04, 1.76, and 1.81, respectively. The levels of most heavy metals in pregnant women and infants were higher in this study than in studies from industrialized western countries. The placenta appears to protect fetuses from cadmium; however, total mercury and methylmercury were able to cross the placenta and accumulate in fetuses.

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          Most cited references31

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          Neurotoxic effects and biomarkers of lead exposure: a review.

          Lead, a systemic toxicant affecting virtually every organ system, primarily affects the central nervous system, particularly the developing brain. Consequently, children are at a greater risk than adults of suffering from the neurotoxic effects of lead. To date, no safe lead-exposure threshold has been identified. The ability of lead to pass through the blood-brain barrier is due in large part to its ability to substitute for calcium ions. Within the brain, lead-induced damage in the prefrontal cerebral cortex, hippocampus, and cerebellum can lead to a variety of neurologic disorders. At the molecular level, lead interferes with the regulatory action of calcium on cell functions and disrupts many intracellular biological activities. Experimental studies have also shown that lead exposure may have genotoxic effects, especially in the brain, bone marrow, liver, and lung cells. Knowledge of the neurotoxicology of lead has advanced in recent decades due to new information on its toxic mechanisms and cellular specificity. This paper presents an overview, updated to January 2009, of the neurotoxic effects of lead with regard to children, adults, and experimental animals at both cellular and molecular levels, and discusses the biomarkers of lead exposure that are useful for risk assessment in the field of environmental health.
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            The role of the placenta in fetal exposure to heavy metals.

            The heavy metals mercury, lead, and cadmium are toxicants, which are well-known to cross the placenta and to accumulate in fetal tissues. Prenatal exposure to mercury and lead poses a health threat particularly to the developing brain. Fetal exposures to lead and cadmium correlate with reduced birth weight and birth size. The placental passage of cadmium is limited suggesting a partial barrier for this metal. It is very likely that metallothionein is responsible for placental storage of the metals especially of cadmium. It is unclear, however, which proteins are involved in placental uptake and efflux of the metals and where the transporters are located at the placental barrier. Hence, only certain aspects of placental metal toxicokinetics are known so far. The metals have also been shown to adversely affect placental functions. Both metal-specific placental transfer and impairment of placental function can explain the relationships between prenatal metal exposures and adverse effects on intrauterine growth and (neuro)development.
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              An assessment of the cord blood:maternal blood methylmercury ratio: implications for risk assessment.

              In the current U.S. Environmental Protection Agency reference dose (RfD) for methylmercury, the one-compartment pharmacokinetic model is used to convert fetal cord blood mercury (Hg) concentration to a maternal intake dose. This requires a ratio relating cord blood Hg concentration to maternal blood Hg concentration. No formal analysis of either the central tendency or variability of this ratio has been done. This variability contributes to the overall variability in the dose estimate. A ratio of 1.0 is implicitly used in the model, but an uncertainty factor adjustment is applied to the central tendency estimate of dose to address variability in that estimate. Thus, incorporation of the cord:maternal ratio and its variability into the estimate of intake dose could result in a significant change in the value of the RfD. We analyzed studies providing data on the cord:maternal blood Hg ratio and conducted a Monte Carlo-based meta-analysis of 10 studies meeting all inclusion criteria to generate a comprehensive estimate of the central tendency and variability of the ratio. This analysis results in a recommended central tendency estimate of 1.7, a coefficient of variation of 0.56, and a 95th percentile of 3.4. By analogy to the impact of the similar hair:blood Hg ratio on the overall variability in the dose estimate, incorporation of the cord:maternal ratio may support a 3-fold uncertainty factor adjustment to the central tendency estimate of dose to account for pharmacokinetic variability. Whether the information generated in this analysis is sufficient to warrant a revision to the RfD will depend on the outcome of a comprehensive reanalysis of the entire one-compartment model. We are currently engaged in such an analysis.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                26 October 2015
                October 2015
                : 12
                : 10
                : 13482-13493
                Affiliations
                [1 ]Department of Preventive Medicine and Dong-A University Heavy Metal Exposure Environmental Health Center, Dong-A University College of Medicine, 49201 Busan, Korea; E-Mails: kimyumi@ 123456dau.ac.kr (Y.-M.K.); medikim@ 123456dau.ac.kr (B.-G.K.)
                [2 ]Dong-A University Heavy Metal Exposure Environmental Health Center, Dong-A University College of Medicine, 49201 Busan, Korea; E-Mail: jchung@ 123456dau.ac.kr
                [3 ]Department of Obstetrics and Gynecology, Ilsin Christian Hospital, 48724 Busan, Korea; E-Mail: banana3592@ 123456hanmail.net
                [4 ]New-born Obstetrics Clinic, 49340 Busan, Korea; E-Mail: dauhpsy@ 123456hanmail.net
                [5 ]Department of Obstetrics and Gynecology, Dong-A University College of Medicine, 49201 Busan, Korea; E-Mails: jwbae@ 123456dau.ac.kr (J.W.B.); hmsobgy@ 123456dau.ac.kr (M.S.H.); jeanjane@ 123456dau.ac.kr (Y.J.C.)
                Author notes
                [* ]Author to whom correspondence should be addressed; E-Mail: yshong@ 123456dau.ac.kr ; Tel.: +82-51-240-2888; Fax: +82-51-253-5729.
                Article
                ijerph-12-13482
                10.3390/ijerph121013482
                4627044
                26516876
                b84cc8ee-c38f-4c4c-847d-3efc860aeeb3
                © 2015 by the authors; licensee MDPI, Basel, Switzerland.

                This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 08 August 2015
                : 22 October 2015
                Categories
                Article

                Public health
                heavy metals,lead,cadmium,mercury,methylmercury,biomonitoring,pregnancy,umbilical cord
                Public health
                heavy metals, lead, cadmium, mercury, methylmercury, biomonitoring, pregnancy, umbilical cord

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